title: Leisure-time physical activity and ischemic stroke risk: the Northern Manhattan Stroke Study.
abstract: OBJECTIVE
  Physical activity reduces the risk of premature death and cardiovascular disease, but the relationship to stroke is less well studied. The objective of this study was to investigate the association between leisure-time physical activity and ischemic stroke in an urban, elderly, multiethnic population.
  
  
  METHODS
  The Northern Manhattan Stroke Study is a population-based incidence and case-control study. Case subjects had first ischemic stroke, and control subjects were derived through random-digit dialing with 1:2 matching for age, sex, and race/ethnicity. Physical activity was recorded through a standardized in-person interview regarding the frequency and duration of 14 activities over the 2 prior weeks. Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals after adjustment for medical and socioeconomic confounders.
  
  
  RESULTS
  Over 30 months, 369 case subjects and 678 control subjects were enrolled. Mean age was 69.9 +/- 12 years; 57% were women, 18% whites, 30% blacks, and 52% Hispanics. Leisure-time physical activity was significantly protective for stroke after adjustment for cardiac disease, peripheral vascular disease, hypertension, diabetes, smoking, alcohol use, obesity, medical reasons for limited activity, education, and season of enrollment (OR = 0.37; 95% confidence interval=0.25 to 0.55). The protective effect of physical activity was detected in both younger and older groups, in men and women, and in whites, blacks, and Hispanics. A dose-response relationship was shown for both intensity (light-moderate activity OR = 0.39; heavy OR = 0.23) and duration (<2 h/wk OR = 0.42; 2 to <5 h/wk OR = 0.35; > or =5 h/wk OR = 0.31) of physical activity.
  
  
  CONCLUSIONS
  Leisure-time physical activity was related to a decreased occurrence of ischemic stroke in our elderly, multiethnic, urban subjects. More emphasis on physical activity in stroke prevention campaigns is needed among the elderly.
authors.affiliation: Department of Neurology, Sergievsky Center, Columbia University College of Physicians and Surgeons and School of Public Health, New York, NY, USA. RLS1@Columbia.edu
authors.forename: R L
authors.initials: RL
authors.lastname: Sacco
authors.forename: R
authors.initials: R
authors.lastname: Gan
authors.forename: B
authors.initials: B
authors.lastname: Boden-Albala
authors.forename: I F
authors.initials: IF
authors.lastname: Lin
authors.forename: D E
authors.initials: DE
authors.lastname: Kargman
authors.forename: W A
authors.initials: WA
authors.lastname: Hauser
authors.forename: S
authors.initials: S
authors.lastname: Shea
authors.forename: M C
authors.initials: MC
authors.lastname: Paik
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000453:epidemiology* / Q000517:prevention & control*; D016022:Case-Control Studies; D016001:Confidence Intervals; D005006:Ethnicity; D015444:Exercise; D005260:Female; D006801:Humans; D015994:Incidence; D007899:Leisure Activities; D008297:Male; D009519:New York City / Q000453:epidemiology; D044469:Racial Groups; D015203:Reproducibility of Results; D012307:Risk Factors; D013177:Sports